Surgery just one hemorrhoid option

Dr. Paul DonohueSyndicated Columnist

Published Sunday, August 16, 2009

DEAR DR. DONOHUE: I have been having a lot of trouble with hemorrhoids. Several years ago, I had them tied, but when I took a trip to India, I really got in trouble. I couldn't eliminate. As soon as I got home, I got myself straightened out by eating prunes, taking Metamucil and watching my diet. The enclosed ad for rubber-banding hemorrhoids appeared in the newspaper. What is your opinion of it? My doctor said I need to have part of my colon removed. I hate that idea. -- E.L.

ANSWER: I have a couple of questions for you. Why does your doctor suggest removing part of your colon? That's not a standard hemorrhoid treatment. What exactly was your problem in India? You say you couldn't eliminate. Do you mean you had constipation? Hemorrhoids don't cause constipation, but constipation can aggravate hemorrhoids. Keeping stools soft greatly lessens hemorrhoid complaints.

Hemorrhoids are veins. External hemorrhoids are located near the anal opening. This region has a plentiful supply of nerves, so external hemorrhoids tend to be painful. Internal hemorrhoids are farther up in the rectum. Fewer nerves supply this area, so internal hemorrhoids are less painful unless a clot forms in them. That is a most unpleasant condition. Internal hemorrhoids become dilated like varicose veins, and they can drop down and even protrude through the anus.

The rubber-band treatment for hemorrhoids is an approved method for getting rid of them. The doctor, using a special instrument, slips a rubber band around the base of the hemorrhoid. The rubber band cuts off blood supply, and within a matter of days the hemorrhoid withers and is sloughed off. Other treatments include injecting hemorrhoids with solutions that dry them up, stapling them so they don't fill with blood, and coagulating them with infrared light. Whether any of these procedures can be used for a specific hemorrhoid problem depends on many factors.

Self-treatment includes sitting in a tub with a few inches of warm water so that the water can bathe the hemorrhoids. The knees should be bent, and the heels brought near the body to allow the water to reach the problem area.